VINO JOHN
Sportspeople need to see the doctor immediately and also take time off for the injury to heal.

Ask a group of medical students whether he/she would specialise in sports medicine, chances are you would get a blank look. Despite growing interest in sports and fitness and the mushrooming of health clubs, awareness of sports medicine remains abysmally low. Dr. P.V. Jayasankar, an orthopaedic surgeon, is working hard to bring this speciality onto centre stage. He was the organising secretary of the recent 26th Annual Conference of the Indian Association of Sports Medicine held in Chennai. Involved and articulate, he spoke to R. KRITHIKA about efforts to create awareness and future plans. Excerpts from an interview:

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HOW would you define sports medicine?

Sports medicine involves a lot of things, like training, nutrition, psychology, prevention and/or early detection of injuries, treatment, rehabilitation ... It is not just for professional sportspeople but for everyone who is into sports. Given the global interest in sports and fitness, it should appeal to a very large number indeed.

What is the level of awareness in this field?

In India, extremely low. It is much better in the West. Here, leave alone the general public, even the sportspeople, their coaches, the administrative bodies and healthcare professionals do not know much about it.

There are a few pockets where there is some awareness or work being done but the overall situation could be better.

What are these pockets and why do they have edge over the others?

V.V. KRISHNAN

Well, Punjab is one. I guess primarily because of the importance given to sports in that State. If you look at the sports scene in India, almost all sports have a few members from Punjab in the national teams. Also the National Institute of Sports in Patiala could have given an added impetus.

Delhi, being the capital and the headquarters of the Sports Development Authority, is also quite good.

The other area happens to be Patna, Bihar. Don't ask me how or why.

You spoke of prevention of injuries. Is it possible to identify or link injuries to specific sports?

I would say that the possibility of injury exists in all sports. Contact sports, by their very nature, have a high injury rate. We can generalise and say that kabbadi players, for instance, tend to have a higher rate of knee injuries, while in cricket, it's the shoulder and back that are most affected. In hockey and football, it would be the ankle and knee. In soccer and boxing there is also the possibility of brain damage due to repeated blows to the head.

What are the important aspects of treating sports related injuries?

The most important is accurate diagnosis. Now there are excellent diagnostic methods like MRI that help differentiate between bone and soft tissue injury. There are effective non-surgical and surgical methods to send the sportspersons back to the field as quickly as possible.

In many cases, the coach tends to treat the injury initially, so by the time they see a doctor, things have worsened.

There should be some kind of protocol so that the coach refers the injury to the doctor immediately. This involves creating awareness among them.

Another problem is that the sportspeople want to rush back into the game. They won't take the time off required for healing. It's always "just the last game" or "just one more match". This aggravates the problem. They must make time for recuperation and healing.

Do you think it will take a long time to establish such a protocol?

Well, it's not going to happen tomorrow. Maybe five years. But it will happen. Especially if awareness increases. As a culture we're not sports conscious.

What role do you see for the administrative bodies controlling sports?

They can do a lot for sports medicine. They can employ doctors and ensure that they keep up with developments in the field. In the West, clubs that manage the various teams have doctors on their payroll.

I know of one doctor who came from the U.S. to practise sports medicine in India. He went back after two years because there was no money, not much work and no recognition. But there will be work if people are aware that such a discipline exists.

May be as the interest in sports grows, the field will also grow.

Is there any difference between treating sportsmen and women?

In general terms, not really. Despite social and cultural restrictions, women have excelled especially in athletics.

But from a medical point of view one issue that has been well documented and is of concern is that women athletes tend to be overzealous in their training and in losing weight. They believe that it improves their performance but it can lead to eating disorders. This in turn causes disturbance in the menstrual cycle, which leads to hormonal imbalances and osteoporosis. That makes them high risk for stress fractures.

So we have to catch them early and counsel them about this aspect.

What about the use or rather misuse of drugs in sports?

That's a real cause for worry. At the State and National level, there is no routine dope testing and so they get away with it.

The trouble is that the technology of detecting drub abuse always lags behind that of manufacturing new drugs.

How interested are medical students in this field?

Not at all. I doubt that if there will be even one or two who choose to specialise in this. It's hard to blame them, there are few jobs and it's not very lucrative.

This is where the administrative bodies can make a difference by recognising sports physicians.

How would you go about creating awareness?

The recent conference was the first step. What we would like is to establish a centre for excellence with therapists, coaches and doctors  for a start in Chennai  so that sportspeople know they can get help there and not have to run around.

Doctors in this field will have to work together and complement each others' efforts to raise the standard of fitness and create awareness.

If asked to list the sub-specialities within this field ...

Well, Training specifics, Nutrition, Psychology, Therapy, Surgery (laughs) Let's get the speciality off the ground first. Then we can worry about sub-specialities.